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Mask leak

Xiaoming Hu, Rehana K Leak, Angus W Thomson, Fang Yu, Yuguo Xia, Lawrence R Wechsler, Jun Chen
The healthy immune system has natural checkpoints that temper pernicious inflammation. Cells mediating these checkpoints include regulatory T cells, regulatory B cells, regulatory dendritic cells, microglia, macrophages and monocytes. Here, we highlight discoveries on the beneficial functions of regulatory immune cells and their mechanisms of action and evaluate their potential use as novel cell-based therapies for brain disorders. Regulatory immune cell therapies have the potential not only to mitigate the exacerbation of brain injury by inflammation but also to promote an active post-injury brain repair programme...
June 20, 2018: Nature Reviews. Neurology
Colin J Morley
Stabilisation and resuscitation of babies at birth is one of the most frequently performed procedures and requires considerable skill. If it is not done well, the baby may suffer prolonged hypoxia and bradycardia. Over the last few years there has been a growing interest in carefully evaluating an infant's condition at birth and the details of what is happening during resuscitation. Clinical assessment of an infant at this time is difficult and often inaccurate. Assessments of heart rate, colour, chest excursions, mask leak, tidal volume, inflation and expiration times, endotracheal intubation, and spontaneous breathing are imprecise...
2018: Neonatology
Maija Leppänen, Bingbing Wu, Jonathan Corey, Michael Yermakov, Sergey A Grinshpun
Millions of workers, including firefighters, use respiratory protective device. The key aspect in assuring the intended protection level of a respirator is its fit. However, even if the respirator originally fits well, the faceseal may be breached during its use. Until now, there have been no practically viable, inexpensive means to monitor the performance of a respirator during actual use. A novel Respirator Seal Integrity Monitor (ReSIM) was developed and recently evaluated on manikins by our team. The objective of this study was to evaluate the ReSIM effectiveness on respirator-wearing firefighters exposed to aerosols while performing simulated routine operational activities...
May 29, 2018: Journal of Occupational and Environmental Hygiene
Collins Kamunde, Mahmoud Sharaf, Nicole MacDonald
Although mitochondria are presumed to emit and consume reactive oxygen species (ROS), the quantitative interplay between the two processes in ROS regulation is not well understood. Here, we probed the role of mitochondrial bioenergetics in H2 O2 metabolism using rainbow trout liver and heart mitochondria. Both liver and heart mitochondria emitted H2 O2 at rates that depended on their metabolic state, with the emission rates (free radical leak) constituting 0.8 to 2.9% and 0.2 to 2.5% of the respiration rate in liver and heart mitochondria, respectively...
May 23, 2018: Free Radical Biology & Medicine
J-H Lee, Y-E Jang, E-H Kim, H-S Kim, J-T Kim
BACKGROUND: The influence of different head and neck positions on ventilation with the Ambu® AuraGain™ remains unevaluated in children. This study assessed the influence of different head and neck positions on ventilation with the AuraGain™ in paediatric patients. METHODS: In this prospective, randomised crossover study, children ≤7 years of age who were scheduled for elective surgery under general anaesthesia were enrolled. An AuraGain™ was placed in all patients; mechanical ventilation was performed using a volume-controlled mode with a tidal volume of 10 mL/kg...
May 24, 2018: Acta Anaesthesiologica Scandinavica
Georg Nilius, Ulrike Domanski, Maik Schroeder, Holger Woehrle, Andrea Graml, Karl-Josef Franke
Purpose: Mucosal drying during continuous positive airway pressure (CPAP) therapy is problematic for many patients. This study assessed the influence of ambient relative humidity (rH) and air temperature (T) in winter and summer on mask humidity during CPAP, with and without mask leak, and with or without heated humidification ± heated tubing. Methods: CPAP (8 and 12 cmH2 O) without humidification (no humidity [nH]), with heated humidification controlled by ambient temperature and humidity (heated humidity [HH]) and HH plus heated tubing climate line (CL), with and without leakage, were compared in 18 subjects with OSA during summer and winter...
2018: Nature and Science of Sleep
Laila Lorenz, Christoph M Rüegger, Eoin O'Currain, Jennifer A Dawson, Marta Thio, Louise S Owen, Susan M Donath, Peter G Davis, C Omar F Kamlin
OBJECTIVE: To compare the suction mask, a new facemask that uses suction to create a seal between the mask and the infant's face, with a conventional soft, round silicone mask during positive pressure ventilation (PPV) in the delivery room in newborn infants >34 weeks of gestation. STUDY DESIGN: Single-center randomized controlled trial in the delivery room. The primary outcome was mask leak. RESULTS: Forty-five infants were studied at a median gestational age of 38...
April 25, 2018: Journal of Pediatrics
Bingbing Wu, Jonathan Corey, Michael Yermakov, Yan Liu, Sergey A Grinshpun
Background: A low-cost real-time Respirator Seal Integrity Monitor (ReSIM) was recently developed to monitor a respirator's actual performance at a workplace. The objective of this study was to evaluate the capability of the new ReSIM prototype in manikin-based laboratory experiments to rapidly detect induced leakage of a half-mask elastomeric respirator. Methods: Two phases of testing were conducted in this study. First, the accuracy of ReSIM measuring an aerosol concentration was assessed by comparing the outputs of ReSIM against a reference optical aerosol spectrometer (OAS) in a flow-through set-up...
April 21, 2018: Annals of Work Exposures and Health
Harihar Vishwanath Hegde, Joshiraj Bandi, Mahantesh S Mudakanagoudar, Kiran A Honnannavar
Background and Aims: Airway used in prone position should be efficacious and safe. The Streamlined Liner of the Pharynx Airway (SLIPA™) and Laryngeal Mask Airway-ProSeal (PLMA) provide better airway seal and protection against aspiration. We planned to evaluate the performance of SLIPA™, PLMA and endotracheal tube (ETT) in prone position. Methods: 114 adult patients undergoing elective surgery in prone position under general anaesthesia were randomised into Group-T (ETT), Group-S (SLIPA™) and Group-P (PLMA)...
March 2018: Indian Journal of Anaesthesia
Chetan B Bhat, Kiran A Honnannavar, Mallanna B Police Patil, Mahantesh S Mudakanagoudar
Introduction: In the past 25 years with the development of various supraglottic airway devices, the armamentarium for airway management has increased. In our study, the laryngeal mask airway (LMA)-ProSeal is compared with the LMA-Classic with respect to as follows: (a) Ease of insertion and number of insertion attempts, (b) Device positional stability and possible oropharyngeal leak, (c) Airway trauma, and (d) Hemodynamic changes; in children aged 3-15 years undergoing elective surgery under general anesthesia, hypothesizing that these would be different...
January 2018: Anesthesia, Essays and Researches
Giorgio Conti, Giorgia Spinazzola, Cesare Gregoretti, Giuliano Ferrone, Andrea Cortegiani, Olimpia Festa, Marco Piastra, Luca Tortorolo, Roberta Costa
BACKGROUND: To compare, in terms of patient-ventilator interaction and performance, a new nasal mask (Respireo, AirLiquide, FR) with the Endotracheal tube (ET) and a commonly used nasal mask (FPM, Fisher and Paykel, NZ) for delivering Pressure Support Ventilation (PSV) in an infant model of Acute Respiratory Failure (ARF). METHODS: An active test lung (ASL 5000) connected to an infant mannequin through 3 different interfaces (Respireo, ET and FPM), was ventilated with a standard ICU ventilator set in PSV...
April 7, 2018: BMC Pulmonary Medicine
Seokha Yoo, Sun-Kyung Park, Won Ho Kim, Min Hur, Jae-Hyon Bahk, Young-Jin Lim, Jin-Tae Kim
BACKGROUND: The purpose of this study was to investigate the influence of different head and neck positions on the performance of the Ambu® AuraGainTM, a novel laryngeal mask with anatomical curvature. METHODS: Oropharyngeal leak pressure, expiratory tidal volume, peak inspiratory pressure, ventilation score, and fibreoptic view score through the AuraGainTM were measured in the neutral, flexed, and extended neck positions as well as the right rotated head and neck position in each patient in a random order...
March 27, 2018: Minerva Anestesiologica
J-L Hanouz, F Le Gall, J-L Gérard, N Terzi, H Normand
BACKGROUND: During preoxygenation, the lack of tight fit between the mask and the patient's face results in inward air leak preventing effective preoxygenation. We hypothesized that non-invasive positive-pressure ventilation and positive end-expiratory pressure (PEEP) could counteract inward air leak. METHODS: Healthy volunteers were randomly assigned to preoxygenated through spontaneous breathing without leak (SB), spontaneous breathing with a calibrated air leak (T-shaped piece between the mouth and the breathing system; SB-leak), or non-invasive positive inspiratory pressure ventilation (inspiratory support +6 cm H2 O; PEEP +5 cm H2 O) with calibrated leak (PPV-leak)...
April 2018: British Journal of Anaesthesia
M D Ivanović, J Petrovic, A Savić, G Gligorić, M Miletić, M Vukčević, B Bojović, Lj Hadžievski, T Allsop, D J Webb
OBJECTIVE: The ventilators involved in non-invasive mechanical ventilation commonly provide ventilator support via a facemask. The interface of the mask with a patient promotes air leaks that cause errors in the feedback information provided by a pneumatic sensor and hence patient-ventilator asynchrony with multiple negative consequences. Our objective is to test the possibility of using chest-wall motion measured by an optical fibre-grating sensor as a more accurate non-invasive ventilator triggering mechanism...
April 26, 2018: Physiological Measurement
Gargi Banerjee, Divya Jain, Indu Bala, Komal Gandhi, Ram Samujh
Background and Aims: Head and neck movements alter the shape of the pharynx, resulting in changes in the oropharyngeal leaking pressures and ventilation with supragottic airway devices. We compared the effect of the different head-and-neck positions on the oropharyngeal leak pressures and ventilation with the I-Gel™ and ProSeal™ laryngeal mask airway (PLMA) in anaesthetised paralysed children. Methods: A total of 70 children were randomly assigned to receive PLMA ( n = 35) or I-Gel™ ( n = 35) for airway management...
February 2018: Indian Journal of Anaesthesia
Francesco Montecchia, Fabio Midulla, Paola Papoff
Measuring work of breathing (WOB) is an intricate task during high-flow nasal cannula (HFNC) therapy because the continuous unidirectional flow toward the patient makes pneumotachography technically difficult to use. We implemented a new method for measuring WOB based on a differential pneumotachography (DP) system, equipped with one pneumotachograph inserted in the HFNC circuit and another connected to a monitoring facemask, combined with a leak correction algorithm (LCA) that corrects flow measurement errors arising from leakage around the monitoring facemask...
April 2018: Medical Engineering & Physics
Yoon Chan Lee, Kyoung Seop Yoon, Sang Yoong Park, So Ron Choi, Chan Jong Chung
Background: The i-gel™ (i-gel) and Laryngeal Mask Airway Supreme™ (LMA Supreme) have been safely used in children. We compared the airway performance of the i-gel and LMA Supreme in infants undergoing general anesthesia. Methods: Sixty infants with American Society of Anesthesiologists physical status I or II were randomly assigned to place either the i-gel or the LMA Supreme. The size 1 or 1.5 of each airway was selected by the weight of infants. The primary outcome variable was oropharyngeal leak pressure (OLP)...
February 2018: Korean Journal of Anesthesiology
Holger Woehrle, Michael Arzt, Andrea Graml, Ingo Fietze, Peter Young, Helmut Teschler, Joachim H Ficker
OBJECTIVE/BACKGROUND: This study investigated the addition of a real-time feedback patient engagement tool on positive airway pressure (PAP) adherence when added to a proactive telemedicine strategy. PATIENTS/METHODS: Data from a German healthcare provider (ResMed Healthcare Germany) were retrospectively analyzed. Patients who first started PAP therapy between 1 September 2009 and 30 April 2014, and were managed using telemedicine (AirView™; proactive care) or telemedicine + patient engagement tool (AirView™ + myAir™; patient engagement) were eligible...
January 2018: Sleep Medicine
Carolina Meira, Fabiola B Joerger, Annette P N Kutter, Andreas Waldmann, Simone K Ringer, Stephan H Böehm, Samuel Iff, Martina Mosing
OBJECTIVE: To compare the efficacy of three continuous positive airway pressure (CPAP) interfaces in dogs on gas exchange, lung volumes, amount of leak during CPAP and rebreathing in case of equipment failure or disconnection. STUDY DESIGN: Randomized, prospective, crossover, experimental trial. ANIMALS: Ten purpose-bred Beagle dogs. METHODS: Dogs were in dorsal recumbency during medetomidine-propofol constant rate infusions, breathing room air...
March 2018: Veterinary Anaesthesia and Analgesia
Matthew T V Chan, Benny K Chow, Thomas Lo, Fanny W Ko, Susanna S Ng, Tony Gin, David S Hui
Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator during mask ventilation by different groups of healthcare workers and coughing bouts. The simulator was programmed to mimic varying severity of lung injury. Exhaled airflow was marked with tiny smoke particles, and highlighted by laser light-sheet. We determined the normalized exhaled air concentration in the leakage jet plume from the light scattered by smoke particles...
January 9, 2018: Scientific Reports
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